The National Institute for Health and Care Excellence (NICE) has said the use of antibiotics for possible sepsis should be more targeted to ensure the right people receive treatment at the right time.
NICE has recommended that clinicians use the NHS England-endorsed National Early Warning Score (NEWS2) that was developed by the Royal College of Physicians to identify acutely ill patients.
NICE says NEWS2 should be used to help assess people with suspected sepsis who are:
- Aged 16 and over
- Not and have not recently been pregnant
- In an acute hospital setting, acute mental health setting, or ambulance
This recommendation is included in an update to NICE’s suspected sepsis guideline, which says those deemed as the most severely ill by NEWS2 should be prioritised and receive broad-spectrum antibiotics within an hour.
“These revisions help end a period of instability…”
Dr Ron Daniels,
UK Sepsis Trust
This is expected to lead to more people being graded at a lower risk, which will reduce the risk of medicines being overused and thus antibiotic resistance.
The updated guidance also aligns with the Academy of Medical Royal Colleges’ statement on the antimicrobial treatment of sepsis.
The UK Sepsis Trust’s founder and joint chief executive, Dr Ron Daniels, said: “We particularly support that the update continues to recommend the identification of high-risk factors, whilst reinforcing the importance of clinical judgement to prevent injudicious use of antibiotics.
“The recommendation for GPs and ambulance services to consider how they give antibiotics to people that are at high risk of sepsis is increasingly relevant as transit times increase, and could be potentially transformational in terms of patient outcomes.”
He continued: “These revisions help end a period of instability, with healthcare professionals previously facing varying guidance from the Academy of Medical Royal Colleges.”
Analysis from the UK Sepsis Trust in 2017 has previously indicated there were 200,000 hospital admissions in England where sepsis was diagnosed.
The trust says if this figure is extrapolated out into the entire UK population, there are at least 245,000 sepsis cases a year.
NICE’s chief medical officer, Professor Jonathan Benger, added: “This useful and useable guidance will help ensure antibiotics are targeted to those at the greatest risk of severe sepsis, so they get rapid and effective treatment. It also supports clinicians to make informed, balanced decisions when prescribing antibiotics.
“We know that sepsis can be difficult to diagnose so it is vital there is clear guidance on the updated NEWS2 so it can be used to identify illness, ensure people receive the right treatment in the right clinical setting and save lives.”
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